Ebola and foreign aid: The cuts, the consequences

Infectious diseases have a habit of capturing the imagination in bad ways. Their cause is invisible — microbes too small to be seen with the naked eye. They spread through hugs and handshakes, turning expressions of love and friendship into something deadly.

Diseases are unsettling — and the more ghastly the effects, the harder people find it to react rationally. So it goes with Ebola.

In the U.S., just three confirmed cases of Ebola had parents pulling their children out of one school after learning that its principal had travelled to Africa – to Zambia, actually, a country far removed from the hot zone.

The problem with panic is that it’s almost always about the wrong things. People aren’t good at gauging risk. Those living hundreds of miles from an outbreak stay home for fear of infection, but blithely ignore the factors that led to the worst-ever outbreak of Ebola in the first place.

There have been 20 major Ebola outbreaks since the disease was first discovered in 1976. Until this year, no single outbreak had ever killed more than 300 people. According to official numbers, the current outbreak has killed around 4,500 people to date; given the fact that many cases go unreported, the true number of deaths may be far higher.

Why is this outbreak different? Previous outbreaks occurred in isolated places; once the disease was recognized, it was easier to use tools like contact tracing and isolation to keep it from spreading. But over the past two decades, Africa has experienced the fastest urban growth rate in the developing world.

In West Africa, that urbanization has manifested itself in towns that are both larger and more plentiful. As these new urban centres develop, the distances between those centres diminishes. As a result, disease has less ground to cover before it reaches densely populated areas.

And as people crowd together, it becomes harder to contain the spread of a disease once it arrives in towns and cities. A combination of heavy rainfall, poor sanitation and unsafe water sources led to a massive cholera epidemic in 2012 that swept through West African slums. There were over 25,000 reported cases — and nearly 400 deaths.

We’re playing catch-up on yet another disaster in the developing world, because we always refuse to act until we feel threatened at home. It’s gutless, morally bankrupt political maneuvering at the expense of human lives — and it needs to stop.

Those same close quarters and poor sanitation are among the factors that have made this year’s Ebola outbreak so deadly.

The other critical factor, of course, has been the lack of health care infrastructure at the epicentre of the outbreak. In September, there were simply no more beds left in Liberia to treat Ebola patients, even as their numbers kept rising.

The thing is, these problems aren’t new. Liberia, Guinea and Sierra Leone all have health systems crippled by decades of political instability and poverty. We knew that people in urban slums around the world live in crowded conditions, without clean water or adequate toilets. We knew these problems existed.

We just didn’t care enough to do anything about it.

Did we learn nothing from SARS back in 2003? That was another outbreak that started in a climate of deep poverty, in China’s Guangdong province. From there, it spread to Hong Kong, Singapore, Vietnam – and Canada.

We should have realized then that, even with a world-class health care system here at home, we can’t always protect against diseases that emerge in the developing world. If empathy couldn’t motivate us to do something about the awful sanitation and public health standards in much of the developing word, an instinct for self-preservation should have.

Instead, Canada cut its foreign aid again last year, just when peer nations were recommitting to international development in the wake of the global financial crisis. Last year’s 11 per cent cut in our foreign aid budget came after $300 million in foreign aid went unspent in 2012. Between 2008 and 2012, the Canadian government cut aid to Guinea, Liberia, and Sierra Leone — the three countries most affected by the Ebola outbreak — by nearly 35 per cent.

Sure, our government is happy to promise money now — though one should note that we’re promising money a lot faster than we’re actually spending it. But money isn’t the only thing that’s needed: West Africa is desperately lacking in qualified health professionals to staff hospitals and train local workers. Cuba has already sent 165 doctors to Sierra Leone and intends to send 296 more to Liberia and Guinea. Meanwhile, we can barely be bothered to spend the money we’ve already earmarked.

Keeping up our foreign aid to West Africa probably wouldn’t have stopped this outbreak. But it might have meant a few more hospital beds for patients, slightly better protective gear for front-line health care workers, and health infrastructure with just a little bit more capacity. It might have put us in a better position to help slow this epidemic. It might have saved some lives.

Instead we’re playing catch-up on yet another disaster in the developing world, because we always refuse to act until we feel threatened at home. It’s gutless, morally bankrupt political maneuvering at the expense of human lives, and it needs to stop. We can do better – and we have, in the past, when we treated aid as a moral imperative, rather than as political leverage.

Foreign aid isn’t a bandage to be applied in a crisis. It only works as part of a long-term commitment, to help build the capacity to avoid crises. Until our government understands that, we’re going to keep chasing the disasters we could have helped the world avoid.

Devon Black is studying law at the University of Victoria. In addition to writing for iPolitics, Devon has worked for the Canadian International Development Agency, Leadership Africa USA and RamRais & Partners.

The views, opinions and positions expressed by all iPolitics columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of iPolitics.

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Devon Black is originally from Calgary. She spent five years in Ottawa working on her bachelor's degree in international development, then moved back out west in 2011 to start a law degree at the University of Victoria. In addition to writing for iPolitics, Devon has worked for the Canadian International Development Agency, Leadership Africa USA (a non-profit based in Washington, D.C.), and RamRais & Partners (an intellectual property law firm in Kuala Lumpur). For fun, Devon likes to argue competitively for the University of Victoria Debate Society and dance to hot jazz from the 1920s. When the weather's nice, you can find her roaming downtown Victoria in search of a good Earl Grey.